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Tackney MS, Williamson E, Cook DG, Limb E, Harris T, Carpenter J. Multiple imputation approaches for epoch-level accelerometer data in trials. Stat Methods Med Res 2023; 32:1936-1960. [PMID: 37519214 PMCID: PMC10563375 DOI: 10.1177/09622802231188518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
Clinical trials that investigate physical activity interventions often use accelerometers to measure step count at a very granular level, for example in 5-second epochs. Participants typically wear the accelerometer for a week-long period at baseline, and for one or more week-long follow-up periods after the intervention. The data is aggregated to provide daily or weekly step counts for the primary analysis. Missing data are common as participants may not wear the device as per protocol. Approaches to handling missing data in the literature have defined missingness on the day level using a threshold on daily weartime, which leads to loss of information on the time of day when data are missing. We propose an approach to identifying and classifying missingness at the finer epoch-level and present two approaches to handling missingness using multiple imputation. Firstly, we present a parametric approach which accounts for the number of missing epochs per day. Secondly, we describe a non-parametric approach where missing periods during the day are replaced by donor data from the same person where possible, or data from a different person who is matched on demographic and physical activity-related variables. Our simulation studies show that the non-parametric approach leads to estimates of the effect of treatment that are least biased while maintaining small standard errors. We illustrate the application of these different multiple imputation strategies to the analysis of the 2017 PACE-UP trial. The proposed framework is likely to be applicable to other digital health outcomes and to other wearable devices.
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Affiliation(s)
- Mia S Tackney
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, UK
| | - Elizabeth Williamson
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, UK
| | - Derek G Cook
- Population Health Research Institute, St George’s, University of London, UK
| | - Elizabeth Limb
- Population Health Research Institute, St George’s, University of London, UK
| | - Tess Harris
- Population Health Research Institute, St George’s, University of London, UK
| | - James Carpenter
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, UK
- MRC Clinical Trials Unit at University College London, UK
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2
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Yamamoto N, Matsumoto T, Sudo T, Miyashita M, Kondo T. Quantitative measurement of finger usage in stroke hemiplegia using ring-shaped wearable devices. J Neuroeng Rehabil 2023; 20:73. [PMID: 37280649 DOI: 10.1186/s12984-023-01199-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Accepted: 05/26/2023] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND In post-stroke rehabilitation, positive use of affected limbs in daily life is important to improve affected upper-limb function. Several studies have quantitatively evaluated the amount of upper-limb activity, but few have measured finger usage. In this study, we used a ring-shaped wearable device to measure upper-limb and finger usage simultaneously in hospitalized patients with hemiplegic stroke and investigated the association between finger usage and general clinical evaluation. METHODS Twenty patients with hemiplegic stroke in an inpatient hospital participated in this study. All patients wore a ring-shaped wearable device on both hands for 9 h on the day of the intervention, and their finger and upper-limb usage were recorded. For the rehabilitation outcome assessments, the Fugl-Meyer Assessment of the Upper Extremity (FMA-UE), Simple Test for Evaluating Hand Function (STEF), Action Research Arm Test (ARAT), Motor Activity Log-14 (MAL), and Functional Independence Measure Motor (FIM-m) were performed and evaluated on the same day as the intervention. RESULTS Finger usage of the affected hand was moderately correlated with STEF ([Formula: see text], [Formula: see text]) and STEF ratio ([Formula: see text], [Formula: see text]). The finger-usage ratio was moderately correlated with FMA-UE ([Formula: see text], [Formula: see text]) and ARAT ([Formula: see text], [Formula: see text]), and strongly correlated with STEF ([Formula: see text], [Formula: see text]) and STEF ratio ([Formula: see text], [Formula: see text]). The upper-limb usage of the affected side was moderately correlated with FMA-UE ([Formula: see text], [Formula: see text]), STEF ([Formula: see text], [Formula: see text]) and STEF ratio ([Formula: see text], [Formula: see text]), and strongly correlated with ARAT ([Formula: see text], [Formula: see text]). The upper-limb usage ratio was moderately correlated with ARAT ([Formula: see text], [Formula: see text]) and STEF ([Formula: see text], [Formula: see text]), and strongly correlated with the STEF ratio ([Formula: see text], [Formula: see text]). By contrast, there was no correlation between MAL and any of the measurements. CONCLUSIONS This measurement technique provided useful information that was not biased by the subjectivity of the patients and therapists.
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Affiliation(s)
- Naoya Yamamoto
- Department of Computer and Information Sciences, Graduate School of Engineering, Tokyo University of Agriculture and Technology, 2-24-16, Naka-cho, Koganei, Tokyo, Japan
- Department of Rehabilitation, Shonan Keiiku Hospital, 4360, Endo, Fujisawa, Kanagawa, Japan
| | - Takato Matsumoto
- Department of Computer and Information Sciences, Graduate School of Engineering, Tokyo University of Agriculture and Technology, 2-24-16, Naka-cho, Koganei, Tokyo, Japan
| | - Tamami Sudo
- Department of Computer and Information Sciences, Graduate School of Engineering, Tokyo University of Agriculture and Technology, 2-24-16, Naka-cho, Koganei, Tokyo, Japan
| | - Megumi Miyashita
- Department of Computer and Information Sciences, Graduate School of Engineering, Tokyo University of Agriculture and Technology, 2-24-16, Naka-cho, Koganei, Tokyo, Japan
| | - Toshiyuki Kondo
- Department of Computer and Information Sciences, Graduate School of Engineering, Tokyo University of Agriculture and Technology, 2-24-16, Naka-cho, Koganei, Tokyo, Japan.
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3
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Park C, Rouzi MD, Atique MMU, Finco MG, Mishra RK, Barba-Villalobos G, Crossman E, Amushie C, Nguyen J, Calarge C, Najafi B. Machine Learning-Based Aggression Detection in Children with ADHD Using Sensor-Based Physical Activity Monitoring. SENSORS (BASEL, SWITZERLAND) 2023; 23:4949. [PMID: 37430862 PMCID: PMC10221870 DOI: 10.3390/s23104949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 05/10/2023] [Accepted: 05/20/2023] [Indexed: 07/12/2023]
Abstract
Aggression in children is highly prevalent and can have devastating consequences, yet there is currently no objective method to track its frequency in daily life. This study aims to investigate the use of wearable-sensor-derived physical activity data and machine learning to objectively identify physical-aggressive incidents in children. Participants (n = 39) aged 7 to 16 years, with and without ADHD, wore a waist-worn activity monitor (ActiGraph, GT3X+) for up to one week, three times over 12 months, while demographic, anthropometric, and clinical data were collected. Machine learning techniques, specifically random forest, were used to analyze patterns that identify physical-aggressive incident with 1-min time resolution. A total of 119 aggression episodes, lasting 7.3 ± 13.1 min for a total of 872 1-min epochs including 132 physical aggression epochs, were collected. The model achieved high precision (80.2%), accuracy (82.0%), recall (85.0%), F1 score (82.4%), and area under the curve (89.3%) to distinguish physical aggression epochs. The sensor-derived feature of vector magnitude (faster triaxial acceleration) was the second contributing feature in the model, and significantly distinguished aggression and non-aggression epochs. If validated in larger samples, this model could provide a practical and efficient solution for remotely detecting and managing aggressive incidents in children.
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Affiliation(s)
- Catherine Park
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA; (C.P.); (M.D.R.); (M.M.U.A.); (M.G.F.); (R.K.M.)
| | - Mohammad Dehghan Rouzi
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA; (C.P.); (M.D.R.); (M.M.U.A.); (M.G.F.); (R.K.M.)
| | - Md Moin Uddin Atique
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA; (C.P.); (M.D.R.); (M.M.U.A.); (M.G.F.); (R.K.M.)
| | - M. G. Finco
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA; (C.P.); (M.D.R.); (M.M.U.A.); (M.G.F.); (R.K.M.)
| | - Ram Kinker Mishra
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA; (C.P.); (M.D.R.); (M.M.U.A.); (M.G.F.); (R.K.M.)
| | - Griselda Barba-Villalobos
- Menninger Department of Psychiatry and Behavioral Sciences and Department of Pediatrics, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX 77030, USA; (G.B.-V.); (E.C.); (C.A.); (J.N.)
| | - Emily Crossman
- Menninger Department of Psychiatry and Behavioral Sciences and Department of Pediatrics, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX 77030, USA; (G.B.-V.); (E.C.); (C.A.); (J.N.)
| | - Chima Amushie
- Menninger Department of Psychiatry and Behavioral Sciences and Department of Pediatrics, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX 77030, USA; (G.B.-V.); (E.C.); (C.A.); (J.N.)
| | - Jacqueline Nguyen
- Menninger Department of Psychiatry and Behavioral Sciences and Department of Pediatrics, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX 77030, USA; (G.B.-V.); (E.C.); (C.A.); (J.N.)
| | - Chadi Calarge
- Menninger Department of Psychiatry and Behavioral Sciences and Department of Pediatrics, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX 77030, USA; (G.B.-V.); (E.C.); (C.A.); (J.N.)
| | - Bijan Najafi
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA; (C.P.); (M.D.R.); (M.M.U.A.); (M.G.F.); (R.K.M.)
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Bourke M, Haddara A, Loh A, Carson V, Breau B, Tucker P. Adherence to the World Health Organization's physical activity recommendation in preschool-aged children: a systematic review and meta-analysis of accelerometer studies. Int J Behav Nutr Phys Act 2023; 20:52. [PMID: 37101226 PMCID: PMC10132436 DOI: 10.1186/s12966-023-01450-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 04/06/2023] [Indexed: 04/28/2023] Open
Abstract
BACKGROUND The World Health Organization (WHO) recommend that preschool-aged children should engage in 180 min of total physical activity (TPA) including 60 min of moderate-to-vigorous physical activity (MVPA) each day. No systematic reviews or meta-analyses have pooled adherence to the recommendation across multiple studies. This study aimed to estimate the prevalence of preschool-aged children achieving the WHO's physical activity recommendation for young children, and determine if the prevalence differed between boys and girls. METHODS Primary literature searches were conducted on six online databases and a machine learning assisted systematic review was used to identify relevant studies. Studies written in English reporting on the prevalence of children aged 3-5 years achieving overall WHO physical activity recommendation or the individual TPA or MVPA aspects of the recommendation measured using accelerometers were eligible for inclusion. Random effects meta-analysis was used to determine the prevalence of preschools achieving the overall WHO recommendation and the individual TPA and MVPA aspect of the recommendation, and to determine difference in prevalence between boys and girls. RESULTS Forty-eight studies reporting on 20,078 preschool-aged children met the inclusion criteria. Based on the most commonly employed accelerometer cut-points across all aspects of the recommendation, 60% (95% Confidence Interval [CI] = 37%, 79%) of preschool-aged children adhered to the overall physical activity recommendation, 78% (95% CI = 38%, 95%) adhered to the TPA aspect of the recommendation, and 90% (95% CI = 81%, 95%) adhered to the MVPA aspect of the recommendation. There was substantial variability is prevalence estimates between different accelerometer cut-points. Girls were significantly less likely to achieve the overall recommendation and the MVPA aspect of the recommendation than boys were. CONCLUSIONS Although there was substantial variability in estimated prevalence of preschool-aged children adhering the WHO physical activity recommendation between various accelerometer cut-points, the weight of available evidence suggests that the majority of young children are adhering to the overall recommendation and the individual TPA and MVPA aspects of the recommendation. Large-scale, intercontinental surveillance studies are needed to further strengthen the evidence regarding the prevalence of preschool-aged children achieving physical activity recommendation globally.
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Affiliation(s)
- Matthew Bourke
- School of Occupational Therapy, Faculty of Health Sciences, Western University, London, ON, Canada.
| | - Ameena Haddara
- School of Occupational Therapy, Faculty of Health Sciences, Western University, London, ON, Canada
| | - Aidan Loh
- School of Occupational Therapy, Faculty of Health Sciences, Western University, London, ON, Canada
| | - Valerie Carson
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada
| | - Becky Breau
- Fowler Kennedy Sport Medicine Clinic, Western University, London, ON, Canada
| | - Patricia Tucker
- School of Occupational Therapy, Faculty of Health Sciences, Western University, London, ON, Canada
- Children's Health Research Institute, London, ON, Canada
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5
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Uher D, Yoon L, Garber CE, Montes J. How is Physical Activity Measured in Spinal Muscular Atrophy and Duchenne Muscular Dystrophy? J Neuromuscul Dis 2023; 10:897-914. [PMID: 37424475 PMCID: PMC10578218 DOI: 10.3233/jnd-230033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2023] [Indexed: 07/11/2023]
Abstract
BACKGROUND Physical activity (PA) provides many substantial benefits to help reduce risk for cardiometabolic disease, improve cognitive function, and improve quality of life. Individuals with neuromuscular disorders (NMDs), such as spinal muscular atrophy (SMA) and Duchenne muscular dystrophy (DMD) are characterized by muscular weakness and fatigue, which limits the capacity to reach the recommended guidelines of PA. Measuring PA in these populations can provide insight to participation in daily activities, track disease progression, and monitor efficacy of drug treatments. OBJECTIVE The objective of this study was to identify how PA is measured in SMA and DMD using instrumented and self-report methods, and how these methods are employed in ambulatory and non-ambulatory groups. METHODS A scoping review was performed to identify studies that reported PA in these neuromuscular disorders. Inclusion was determined after a multi-stage review process by several reviewers, followed by an in-depth analysis of metrics reported by each tool that was used. RESULTS A total of nineteen studies were identified and included in this review. Sixteen studies included instrumented measures and four studies utilized self-reported measures, with eleven studies also reporting PA information from a non-ambulatory group. A variety of metrics have been reported using both classes of measurement tools. CONCLUSION Although a wide variety of research exists that details both instrumented and self-reported measurement tools, feasibility, cost, and study aims are important factors to consider in addition to testing methodology when selecting which type of tool to use. We recommend using a combination of instrumented and self-report measures to provide context to the PA measured in these populations. Improvements in both instrumented and self-report methodologies will add valuable knowledge about the disease burden and efficacy of treatment and disease management methods in SMA and DMD.
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Affiliation(s)
- David Uher
- Department of Rehabilitation and Regenerative Medicine, Columbia University Irving Medical Center, New York, NY, USA
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY, USA
| | - Lisa Yoon
- Department of Rehabilitation and Regenerative Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Carol Ewing Garber
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY, USA
| | - Jacqueline Montes
- Department of Rehabilitation and Regenerative Medicine, Columbia University Irving Medical Center, New York, NY, USA
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6
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Zhang J, Merikangas KR, Li H, Shou H. TWO-SAMPLE TESTS FOR MULTIVARIATE REPEATED MEASUREMENTS OF HISTOGRAM OBJECTS WITH APPLICATIONS TO WEARABLE DEVICE DATA. Ann Appl Stat 2022; 16:2396-2416. [PMID: 38037595 PMCID: PMC10688324 DOI: 10.1214/21-aoas1596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
Repeated observations have become increasingly common in biomedical research and longitudinal studies. For instance, wearable sensor devices are deployed to continuously track physiological and biological signals from each individual over multiple days. It remains of great interest to appropriately evaluate how the daily distribution of biosignals might differ across disease groups and demographics. Hence, these data could be formulated as multivariate complex object data, such as probability densities, histograms, and observations on a tree. Traditional statistical methods would often fail to apply, as they are sampled from an arbitrary non-Euclidean metric space. In this paper we propose novel, nonparametric, graph-based two-sample tests for object data with the same structure of repeated measures. We treat the repeatedly measured object data as multivariate object data, which requires the same number of repeated observations per individual but eliminates any assumptions on the errors of the repeated observations. A set of test statistics are proposed to capture various possible alternatives. We derive their asymptotic null distributions under the permutation null. These tests exhibit substantial power improvements over the existing methods while controlling the type I errors under finite samples as shown through simulation studies. The proposed tests are demonstrated to provide additional insights on the location, inter- and intra-individual variability of the daily physical activity distributions in a sample of studies for mood disorders.
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Affiliation(s)
- Jingru Zhang
- Division of Biostatistics, Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine
| | - Kathleen R. Merikangas
- Genetic Epidemiology Research Branch, National Institute of Mental Health, National Institutes of Health
| | - Hongzhe Li
- Division of Biostatistics, Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine
| | - Haochang Shou
- Division of Biostatistics, Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine
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7
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Bezuidenhout L, Joseph C, Einarsson U, Thurston C, Hagströmer M, Moulaee Conradsson D. Accelerometer assessed upper limb activity in people with stroke: a validation study considering ambulatory and non-ambulatory activities. Disabil Rehabil 2022; 44:8463-8470. [PMID: 34904504 DOI: 10.1080/09638288.2021.2012838] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
PURPOSE Accelerometry measurements are a promising method to provide quantitative information of upper limb function in daily life post stroke. Our purpose was to investigate i) the validity of accelerometer-based vector magnitude ratios (VMR) to distinguish upper limb function between individuals post-stroke and healthy controls during ambulatory and non-ambulatory activities and, ii) the association between the VMR and clinical assessment of upper limb function for individuals post-stroke. METHODS Forty persons with stroke and 32 healthy controls wore wrist and hip accelerometers while performing three upper limb activities in a clinical setting and during three days in daily living. Clinical assessment of upper limb function was assessed with the Chedoke-McMaster Stroke Assessment measure and ABILHand. RESULTS In the clinical setting and daily living, the VMR was significantly lower for individuals post-stroke compared to controls during non-ambulatory activities but not during ambulatory activities. There was a moderate to strong association between VMR and clinical assessment of upper limb function during all conditions, except for walking in the clinical setting. CONCLUSION The VMR could be used as a sensitive objective marker to measure upper limb function post-stroke during ambulatory and non-ambulatory daily activities.Implications for rehabilitationAccelerometer-based assessment of upper limb function is a sensitive measure of upper limb function post stroke during different activity domains.Accelerometers-based assessment of arm function can detect differences in arm function outside the clinical setting (daily living) over a prolonged period that are not always identified by clinical assessment or perceived ability.
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Affiliation(s)
- Lucian Bezuidenhout
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden
| | - Conran Joseph
- Department of Health and Rehabilitation Sciences, Division of Physiotherapy, Stellenbosch University, Cape Town, South Africa
| | - Ulrika Einarsson
- Medical unit Occupational therapy & Physiotherapy, Theme Women's Health and Allied Health Professional, Karolinska University Hospital, Stockholm, Sweden
| | - Charlotte Thurston
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden
| | - Maria Hagströmer
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden.,Academic Primary Care Centre, Region Stockholm, Sweden
| | - David Moulaee Conradsson
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden.,Medical unit Occupational therapy & Physiotherapy, Theme Women's Health and Allied Health Professional, Karolinska University Hospital, Stockholm, Sweden
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8
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Aljuhani O, Alsuwailem R, Al-Salawi A, Sandercock G. Physical Activity and Sedentary Behaviors in Primary School Children in Saudi Arabia during the COVID-19 Pandemic: Association with Parents' Behaviors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192013304. [PMID: 36293883 PMCID: PMC9602739 DOI: 10.3390/ijerph192013304] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/11/2022] [Accepted: 10/12/2022] [Indexed: 06/01/2023]
Abstract
During the COVID-19 pandemic, a few studies used accelerometers to assess physical activity (PA) and sedentary behavior in the family context. This study aimed to assess children and parents' moderate and vigorous physical activity (MVPA) and sedentary time, as well as their relationship in MVPA and sedentary time. Data were collected from 30 parent-child dyads during the COVID-pandemic for seven days, using a hip-worn accelerometer. Children and parents engaged in 65.6 and 34.6 min/day in MVPA and 442.2 and 427.9 min/day sedentary, respectively. There was no evidence of gender difference in MVPA and sedentary between boys and girls. Male parent spent more time in MVPA than female parents. A total of 50% of children and 53.3% of parents met the recommended PA. Children's MVPA and sedentary time were both correlated with that of their parents. Adjusted linear regression showed that only child MVPA was negatively associated with their parents' MVPA. There is evidence that multi-level interventions involving parents and children are more effective than interventions focusing on a single group. This study also provides evidence to support the link between MVPA and sedentary time between parents and children. Generalization of the findings is difficult due to the bias of self-selection sample.
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Affiliation(s)
- Osama Aljuhani
- Department of Physical Education, College of Sport Sciences and Physical Activity, King Saud University, Riyadh 4545, Saudi Arabia
| | - Rola Alsuwailem
- Department of Exercise Physiology, College of Sport Sciences and Physical Activity, King Saud University, Riyadh 4545, Saudi Arabia
| | - Abdulelah Al-Salawi
- Department of Sport and Recreation Management, College of Sport Sciences and Physical Activity, King Saud University, Riyadh 4545, Saudi Arabia
| | - Gavin Sandercock
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Colchester CO4 3SQ, UK
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9
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Traynor O, McCrorie P, Chng NR, Martin A. Evaluating Outdoor Nature-Based Early Learning and Childcare Provision for Children Aged 3 Years: Protocol of a Feasibility and Pilot Quasi-Experimental Design. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:7461. [PMID: 35742709 PMCID: PMC9224218 DOI: 10.3390/ijerph19127461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/14/2022] [Accepted: 06/15/2022] [Indexed: 02/04/2023]
Abstract
Systematic reviews have demonstrated the scarcity of well-designed evaluations investigating outdoor nature-based play and learning provision for children in the early learning and childcare (ELC) sector among global Western countries. This study will examine the feasibility and acceptability of the programme and the evaluation design of outdoor nature-based play and learning provision across urban ELC settings in a Scottish metropolitan city. Six ELC settings with different outdoor nature-based play delivery models will be recruited. One trial design will be tested: a quasi-experimental comparison of children attending three different models of outdoor play and learning provision. Measures will be assessed at baseline and five weeks later. Key feasibility questions include: recruitment and retention of ELC settings and children; suitability of statistical matching based on propensity score; completeness of outcome measures. Process evaluation will assess the acceptability of trial design methods and provision of outdoor nature-based play among ELC educators. These questions will be assessed against pre-defined progression criteria. This feasibility study will inform a powered effectiveness evaluation and support policy making and service delivery in the Scottish ELC sector.
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Affiliation(s)
- Oliver Traynor
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, 99 Berkeley Street, Glasgow G3 7HR, UK; (P.M.); (N.R.C.); (A.M.)
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10
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Leppänen MH, Migueles JH, Abdollahi AM, Engberg E, Ortega FB, Roos E. Comparing estimates of physical activity in children across different cut-points and the associations with weight status. Scand J Med Sci Sports 2022; 32:971-983. [PMID: 35253276 PMCID: PMC9311199 DOI: 10.1111/sms.14147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 02/14/2022] [Accepted: 02/16/2022] [Indexed: 11/28/2022]
Abstract
This study aimed to compare sedentary time (SED) and intensity-specific physical activity (PA) estimates and the associations of SED and PA with body mass index (BMI) and waist circumference (WC) using three different sets of cut-points in preschool-aged children. A total of 751 children (4.7 ± 0.9 years, boys 52.7%) wore an ActiGraph GT3X+BT accelerometer on their hip for 7 days (24 h). Euclidean norm -1 G with negative values rounded to zero (ENMO) and activity counts from vertical axis (VACounts) and vector magnitude (VMCounts) were derived. Estimates of SED and light, moderate, vigorous, and moderate-to-vigorous PA (MVPA) were calculated for commonly used cut-points by Hildebrand et al., Butte et al., and Evenson et al. Furthermore, the prevalence of meeting the PA recommendation, 180 min/day of which at least 60 min/day being MVPA, were assessed for the cut-points. Multilevel mixed analysis was used to examine associations of SED and PA with BMI and WC. In accordance with the results, SED and PA intensity estimates differed largely across cut-points (i.e., SED = 22-341 min/day; light PA = 52-257 min/day; moderate PA = 5-18 min/day; vigorous PA = 7-17 min/day; MVPA = 13-35 min/day), and the prevalence of children meeting the PA recommendation varied from 4% to 70%. Associations of SED and PA with BMI or WC varied between the cut-points. Our results indicate that SED and PA estimates in preschool-aged children between studies using these cut-points are poorly comparable. Methods facilitating accelerometer-derived PA estimate comparison between studies are highly warranted.
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Affiliation(s)
- Marja H Leppänen
- Folkhälsan Research Center, Helsinki, Finland.,Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Jairo H Migueles
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.,PROFITH "PROmoting FITness and Health Through Physical Activity" Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Anna M Abdollahi
- Folkhälsan Research Center, Helsinki, Finland.,Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Elina Engberg
- Folkhälsan Research Center, Helsinki, Finland.,Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland
| | - Francisco B Ortega
- PROFITH "PROmoting FITness and Health Through Physical Activity" Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain.,Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.,Department of Biosciences and Nutrition, Karolinska Institutet, NEO, Huddinge, Sweden
| | - Eva Roos
- Folkhälsan Research Center, Helsinki, Finland.,Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden.,Department of Public Health, University of Helsinki, Helsinki, Finland
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11
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Thinking inside the box: The future of young children's physical activity and the home environment. Soc Sci Med 2022; 301:114930. [PMID: 35344777 PMCID: PMC9350970 DOI: 10.1016/j.socscimed.2022.114930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 02/07/2022] [Accepted: 03/15/2022] [Indexed: 11/20/2022]
Abstract
Parrish et al.'s (2021) investigation of caregiver perceptions of preschoolers' physical activity (PA) within the home environment posits important opportunities for public policy to consider space and available opportunities for PA for preschoolers. This study uncovered qualitative themes on preschoolers' PA in the home, referencing the use of indoor and outdoor spaces, adaptations within the home, interplay between space and caregiving, and variability in child's PA. This work sparks a discussion into the current understanding of the home environment for preschooler PA and future research directions. We propose three main areas to bring forward physical activity and public health research, including 1) role of policies and community (e.g., societal norms) on the home environment and child physical activity, 2) reimagination of the home environment beyond the physical components as a complex system, and 3) advanced measurement of child physical activity using modern technology. Merging these new opportunities with past efforts may help design and facilitate healthier PA and movement patterns for preschoolers now and into the future.
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12
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Weekday and Weekend Physical Activity of Preschool Children in Relation to Selected Socioeconomic Indicators. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19094999. [PMID: 35564395 PMCID: PMC9099735 DOI: 10.3390/ijerph19094999] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 04/16/2022] [Accepted: 04/18/2022] [Indexed: 11/17/2022]
Abstract
Physical activity (PA) is as vital for improving the health of young children as it is positively associated with a broad range of psychological, cognitive, and cardio-metabolic outcomes. The aims of this study were to: (1) to assess the level of PA and meeting the WHO recommendations: moderate-to-vigorous physical activity (MVPA) and the number of steps in Polish preschool boys and girls on weekdays and on weekends; (2) to investigate the relationship between selected socioeconomic indicators (self-reported by parents) and PA, including meeting the WHO recommendation for daily MVPA and the number of steps on weekdays and on weekends among Polish preschoolers. Data were collected in the 2017/2018 school year. The study included a total of 522 boys and girls both aged between 5 and 6 years. The ActiGraph GT3X-BT tri-axial accelerometer was used to measure PA. Selected socioeconomic indicators as well as parental body weight and body height were self-reported by parents/caregivers using a questionnaire. In most of the PA indicators analyzed for girls (moderate, vigorous, total MVPA, and steps/day), the averages were higher during the week than during the weekend. Moreover, significantly more boys met the criteria of MVPA, both on weekdays and over the weekend (32.3% boys and 19.2% girls on weekdays and 31.1% boys and 18.1% girls on weekends). Additionally, more boys met the step recommendations, but only on weekends (15.5% boys and 6.6% girls). It was found that if there were two people in a household, there was an almost a three-fold greater chance (adj. OR = 2.94, p = 0.032) of meeting the MVPA criterion with an even stronger association (over fivefold greater chance) in meeting the step recommendation (adj. OR = 5.56, p = 0.033). The differences in the day schedule may potentially contribute with the level of PA in girls. Among the analyzed selected socioeconomic indicators, only the number of people in a household had a significant association on PA.
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13
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Altenburg TM, de Vries L, Op den Buijsch R, Eyre E, Dobell A, Duncan M, Chinapaw MJM. Cross-validation of cut-points in preschool children using different accelerometer placements and data axes. J Sports Sci 2022; 40:379-385. [PMID: 35040373 DOI: 10.1080/02640414.2021.1994726] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The present study cross-validated various cut-points to assess physical activity and sedentary behaviour in preschoolers, using hip- and wrist-worn accelerometers and both vertical axis and vector magnitude data. Secondly, we examined the influence of epoch length on time estimates of physical activity and sedentary behaviour. Sixty-four preschoolers (34 girls) wore two accelerometers, on their right hip and dominant wrist, during 1 hour of free play. Preschoolers' activities were observed by two trained researchers. Area under the curve (AUC) was calculated for the receiving operating characteristic (ROC) curves as a measure of precision. AUC ranges were 0.603-0.723 for sedentary behaviour, 0.472-0.545 for light physical activity and 0.503-0.661 for moderate-to-vigorous physical activity (MVPA), indicating poor to fair precision. Percentage of time classified as sedentary behaviour, light or MVPA according to observation and accelerometer data varied largely between cut-points, accelerometer placements and axes. The influence of epoch length on time estimates was minimal across cut-points, except for one hip-based vector magnitude cut-point. Across all accelerometer placements and data axes, no set of cut-points demonstrated adequate precision for sedentary behaviour, light physical activity and MVPA. The highly variable and omnidirectional activity pattern of preschoolers may explain the lack of adequate cut-points.
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Affiliation(s)
- Teatske M Altenburg
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam Umc, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Lotte de Vries
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam Umc, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Rianne Op den Buijsch
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam Umc, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Emma Eyre
- School of Life Sciences, Coventry University, James Starley Building, Coventry, UK
| | - Alexandra Dobell
- School of Life Sciences, Coventry University, James Starley Building, Coventry, UK
| | - Michael Duncan
- School of Life Sciences, Coventry University, James Starley Building, Coventry, UK
| | - Mai J M Chinapaw
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam Umc, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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14
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Bent B, Cho PJ, Wittmann A, Thacker C, Muppidi S, Snyder M, Crowley MJ, Feinglos M, Dunn JP. Non-invasive wearables for remote monitoring of HbA1c and glucose variability: proof of concept. BMJ Open Diabetes Res Care 2021; 9:9/1/e002027. [PMID: 36170350 PMCID: PMC8208014 DOI: 10.1136/bmjdrc-2020-002027] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 05/09/2021] [Indexed: 01/02/2023] Open
Abstract
INTRODUCTION Diabetes prevalence continues to grow and there remains a significant diagnostic gap in one-third of the US population that has pre-diabetes. Innovative, practical strategies to improve monitoring of glycemic health are desperately needed. In this proof-of-concept study, we explore the relationship between non-invasive wearables and glycemic metrics and demonstrate the feasibility of using non-invasive wearables to estimate glycemic metrics, including hemoglobin A1c (HbA1c) and glucose variability metrics. RESEARCH DESIGN AND METHODS We recorded over 25 000 measurements from a continuous glucose monitor (CGM) with simultaneous wrist-worn wearable (skin temperature, electrodermal activity, heart rate, and accelerometry sensors) data over 8-10 days in 16 participants with normal glycemic state and pre-diabetes (HbA1c 5.2-6.4). We used data from the wearable to develop machine learning models to predict HbA1c recorded on day 0 and glucose variability calculated from the CGM. We tested the accuracy of the HbA1c model on a retrospective, external validation cohort of 10 additional participants and compared results against CGM-based HbA1c estimation models. RESULTS A total of 250 days of data from 26 participants were collected. Out of the 27 models of glucose variability metrics that we developed using non-invasive wearables, 11 of the models achieved high accuracy (<10% mean average per cent error, MAPE). Our HbA1c estimation model using non-invasive wearables data achieved MAPE of 5.1% on an external validation cohort. The ranking of wearable sensor's importance in estimating HbA1c was skin temperature (33%), electrodermal activity (28%), accelerometry (25%), and heart rate (14%). CONCLUSIONS This study demonstrates the feasibility of using non-invasive wearables to estimate glucose variability metrics and HbA1c for glycemic monitoring and investigates the relationship between non-invasive wearables and the glycemic metrics of glucose variability and HbA1c. The methods used in this study can be used to inform future studies confirming the results of this proof-of-concept study.
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Affiliation(s)
- Brinnae Bent
- Biomedical Engineering, Duke University, Durham, North Carolina, USA
| | - Peter J Cho
- Biomedical Engineering, Duke University, Durham, North Carolina, USA
| | - April Wittmann
- Endocrinology, Duke University Health System, Durham, North Carolina, USA
| | - Connie Thacker
- Endocrinology, Duke University Health System, Durham, North Carolina, USA
| | - Srikanth Muppidi
- Department of Medicine, Stanford University, Stanford, California, USA
| | - Michael Snyder
- Department of Medicine, Stanford University, Stanford, California, USA
| | - Matthew J Crowley
- Endocrinology, Duke University Health System, Durham, North Carolina, USA
| | - Mark Feinglos
- Endocrinology, Duke University Health System, Durham, North Carolina, USA
| | - Jessilyn P Dunn
- Biomedical Engineering, Duke University, Durham, North Carolina, USA
- Biostatistics and Bioinformatics, Duke University, Durham, North Carolina, USA
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15
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Wyszyńska J, Matłosz P, Szybisty A, Dereń K, Mazur A, Herbert J. The association of actigraphic sleep measures and physical activity with excess weight and adiposity in kindergarteners. Sci Rep 2021; 11:2298. [PMID: 33504862 PMCID: PMC7840732 DOI: 10.1038/s41598-021-82101-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Accepted: 01/13/2021] [Indexed: 11/25/2022] Open
Abstract
Insufficient sleep duration and physical activity (PA) are known risk factors for overweight and obesity in children; however, there are no studies on comprehensive associations of objectively-measured sleep parameters and PA with excess weight and excess adiposity in kindergarteners. Therefore, the aim of this study was to determine the associations between objectively measured sleep parameters and PA with excess weight and excess adiposity, defined as BMI ≥ 85th percentile and body fat percentage (BFP) ≥ 85th percentile, respectively. Sleep parameters and PA were measured in 676 subjects aged 5–6 years using accelerometers for 7 days, worn at the participant’s hip. Bioelectrical impedance analysis was used to estimate BFP. In the total sample, lower sleep duration, sleep efficiency, vigorous PA and the number of steps per day were associated with excess weight. However, excess adiposity was associated with lower sleep duration, total PA, vigorous PA, moderate-to-vigorous physical activity (MVPA) and the number of steps per day. Logistic regression by the stepwise progressive method showed that the strongest predictor of excess adiposity in boys and girls was vigorous PA, while the strongest predictor of excess weight in boys was sleep efficiency. A holistic approach to health targeting all of these factors synergistically is needed to optimize the effectiveness of obesity prevention and treatment interventions.
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Affiliation(s)
- Justyna Wyszyńska
- Institute of Health Sciences, Medical College, Rzeszow University, Rzeszow, Poland. .,Centre for Innovative Research in Medical and Natural Sciences, University of Rzeszow, Rzeszow, Poland.
| | - Piotr Matłosz
- Institute of Physical Culture Sciences, Medical College, Rzeszow University, Rzeszow, Poland
| | - Agnieszka Szybisty
- Institute of Physical Culture Sciences, Medical College, Rzeszow University, Rzeszow, Poland
| | - Katarzyna Dereń
- Institute of Health Sciences, Medical College, Rzeszow University, Rzeszow, Poland.,Centre for Innovative Research in Medical and Natural Sciences, University of Rzeszow, Rzeszow, Poland
| | - Artur Mazur
- Institute of Medical Sciences, Medical College, Rzeszow University, Rzeszow, Poland
| | - Jarosław Herbert
- Institute of Physical Culture Sciences, Medical College, Rzeszow University, Rzeszow, Poland
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16
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Aasdahl L, Nilsen TIL, Meisingset I, Nordstoga AL, Evensen KAI, Paulsen J, Mork PJ, Skarpsno ES. Genetic variants related to physical activity or sedentary behaviour: a systematic review. Int J Behav Nutr Phys Act 2021; 18:15. [PMID: 33482856 PMCID: PMC7821484 DOI: 10.1186/s12966-020-01077-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 12/16/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Research shows that part of the variation in physical activity and sedentary behaviour may be explained by genetic factors. Identifying genetic variants associated with physical activity and sedentary behaviour can improve causal inference in physical activity research. The aim of this systematic review was to provide an updated overview of the evidence of genetic variants associated with physical activity or sedentary behaviour. METHODS We performed systematic literature searches in PubMed and Embase for studies published from 1990 to April 2020 using keywords relating to "physical activity", "exercise", "sedentariness" and "genetics". Physical activity phenotypes were either based on self-report (e.g., questionnaires, diaries) or objective measures (e.g., accelerometry, pedometer). We considered original studies aiming to i) identify new genetic variants associated with physical activity or sedentary behaviour (i.e., genome wide association studies [GWAS]), or ii) assess the association between known genetic variants and physical activity or sedentary behaviour (i.e., candidate gene studies). Study selection, data extraction, and critical appraisal were carried out by independent researchers, and risk of bias and methodological quality was assessed for all included studies. RESULTS Fifty-four out of 5420 identified records met the inclusion criteria. Six of the included studies were GWAS, whereas 48 used a candidate gene approach. Only one GWAS and three candidate gene studies were considered high-quality. The six GWAS discovered up to 10 single nucleotide polymorphisms (SNPs) associated with physical activity or sedentariness that reached genome-wide significance. In total, the candidate gene studies reported 30 different genes that were associated (p < 0.05) with physical activity or sedentary behaviour. SNPs in or close to nine candidate genes were associated with physical activity or sedentary behaviour in more than one study. CONCLUSION GWAS have reported up to 10 loci associated with physical activity or sedentary behaviour. Candidate gene studies have pointed to some interesting genetic variants, but few have been replicated. Our review highlights the need for high-quality GWAS in large population-based samples, and with objectively assessed phenotypes, in order to establish robust genetic instruments for physical activity and sedentary behaviour. Furthermore, consistent replications in GWAS are needed to improve credibility of genetic variants. TRIAL REGISTRATION Prospero CRD42019119456 .
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Affiliation(s)
- Lene Aasdahl
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Postboks 8905, MTFS, 7491, Trondheim, Norway. .,Unicare Helsefort Rehabilitation Centre, Rissa, Norway.
| | - Tom Ivar Lund Nilsen
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Postboks 8905, MTFS, 7491, Trondheim, Norway.,Clinic of Anaesthesia and Intensive Care, St. Olavs Hospital, Trondheim, Norway
| | - Ingebrigt Meisingset
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Postboks 8905, MTFS, 7491, Trondheim, Norway
| | - Anne Lovise Nordstoga
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Postboks 8905, MTFS, 7491, Trondheim, Norway
| | - Kari Anne I Evensen
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Postboks 8905, MTFS, 7491, Trondheim, Norway.,Department of Clinical and Molecular Medicine, NTNU, Trondheim, Norway.,Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway.,Unit for Physiotherapy Services, Trondheim, Norway
| | - Julie Paulsen
- Department of Medical Genetics, St. Olavs Hospital, Trondheim, Norway
| | - Paul Jarle Mork
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Postboks 8905, MTFS, 7491, Trondheim, Norway
| | - Eivind Schjelderup Skarpsno
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Postboks 8905, MTFS, 7491, Trondheim, Norway.,Department of Neurology and Clinical Neurophysiology, St. Olavs Hospital, Trondheim, Norway
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17
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Wyszyńska J, Matłosz P, Asif M, Szybisty A, Lenik P, Dereń K, Mazur A, Herbert J. Association between objectively measured body composition, sleep parameters and physical activity in preschool children: a cross-sectional study. BMJ Open 2021; 11:e042669. [PMID: 33472785 PMCID: PMC7818825 DOI: 10.1136/bmjopen-2020-042669] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVE Associations between self-reported sleep duration and obesity indices in children are well recognised; however, there are no studies on associations between objectively measured other sleep parameters and physical activity with body composition in preschoolers. Therefore, the aim of this study was to determine the associations between sleep parameters and moderate-to-vigorous physical activity (MVPA) with body composition indices in preschoolers using objective measures. DESIGN A cross-sectional study. PARTICIPANTS The study group consisted of 676 children aged 5-6 years, who were enrolled in kindergartens in the 2017/2018 school year. OUTCOME MEASURES Sleep parameters and MVPA were measured using accelerometers for 7 days. Bioelectrical impedance analysis was used to estimate body composition. RESULTS Sleep duration and sleep efficiency were inversely associated with body fat percentage (BFP) (β=-0.013 and β from -0.311 to -0.359, respectively) and body mass index (BMI) (β from -0.005 to -0.006 and from -0.105 to -0.121, respectively), and directly associated with fat-free mass (FFM) (β from 0.010 to 0.011 and from 0.245 to 0.271, respectively) and muscle mass (β from 0.012 to 0.012 and from 0.277 to 0.307, respectively) in unadjusted and adjusted models. BFP was inversely associated with MVPA and positively associated with number of awakenings and sleep periods. Number of sleep periods was inversely associated with FFM, and positively with BMI and muscle mass. Correlation matrix indicated significant correlation between BFP, FFM and muscle mass with sleep duration, sleep efficiency, number of sleep periods and MVPA. CONCLUSIONS Periodic assessment of sleep parameters and MVPA in relation to body composition in preschool children may be considered, especially in those who are at risk for obesity.
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Affiliation(s)
- Justyna Wyszyńska
- Institute of Health Sciences, Medical College, University of Rzeszów, Rzeszow, Poland
| | - Piotr Matłosz
- Institute of Physical Culture Sciences, Medical College, University of Rzeszów, Rzeszow, Poland
| | - Muhammad Asif
- Department of Statistics, Govt. Degree College, Qadir Pur Raan, Multan, Pakistan
| | - Agnieszka Szybisty
- Institute of Physical Culture Sciences, Medical College, University of Rzeszów, Rzeszow, Poland
| | - Paweł Lenik
- Institute of Physical Culture Sciences, Medical College, University of Rzeszów, Rzeszow, Poland
| | - Katarzyna Dereń
- Institute of Health Sciences, Medical College, University of Rzeszów, Rzeszow, Poland
| | - Artur Mazur
- Institute of Medical Sciences, Medical College, University of Rzeszów, Rzeszow, Poland
| | - Jarosław Herbert
- Institute of Physical Culture Sciences, Medical College, University of Rzeszów, Rzeszow, Poland
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18
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Dooley EE, Pettee Gabriel K, Kohl HW, Durand CP, Hoelscher DM, Byrd-Williams CE. Adiposity, cardiovascular, and health-related quality of life indicators and the reallocation of waking movement behaviors in preschool children with overweight and obesity: An isotemporal data analysis. PLoS One 2020; 15:e0242088. [PMID: 33170898 PMCID: PMC7654794 DOI: 10.1371/journal.pone.0242088] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 10/26/2020] [Indexed: 12/31/2022] Open
Abstract
Background Isotemporal substitution evaluates hypothetical time replacement scenarios of physical movement on health, with few studies conducted among ethnically diverse preschool-aged populations. This study examines the reallocation of waking movement behaviors on adiposity, cardiovascular, and quality of life indicators among low-income, majority Hispanic preschool-aged youth (2–5 years) with overweight. Methods Participants wore an ActiGraph monitor (waist) and completed adiposity, cardiovascular, and health-related quality of life health assessments. Covariates included age, sex, ethnicity, and socioeconomic status. The isotemporal substitution approach was employed to address study aims. Results Complete data were available for 131 preschoolers. For boys, reallocating 5 minutes of stationary time with light intensity, moderate to vigorous intensity, or total physical activity showed a relation with beneficial reductions in adiposity indicators; for girls, these relations were statistically null. For boys and girls, reallocating 5 minutes of stationary time [-2.2 (95% CI: -3.7, -0.7) mmHg], light intensity [-2.1 (95% CI: -3.7, -0.7) mmHg], or moderate intensity activity [-2.7 (95% CI: -5.0, -0.4) mmHg] to vigorous intensity activity was related to favorable systolic blood pressure. Reallocating 5 minutes of stationary time to moderate to vigorous intensity activity [0.6 (95% CI: -1.0, -0.1) mmHg] or total physical activity [-0.2 (95% CI: -0.3, -0.01) mmHg] was related to lowered systolic blood pressure. Reallocating 5 minutes of stationary time to moderate to vigorous intensity activity [0.6 (95% CI: -1.1, -0.02) bpm] was related to lowered resting heart rate. No significant results for quality of life were found. Conclusion Reallocation of time from stationary time to other movement behaviors is associated with several favorable adiposity and cardiovascular health outcomes among preschool children with overweight and obesity.
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Affiliation(s)
- Erin E. Dooley
- Risk Factor Assessment Branch, Epidemiology and Genomics Research Program, National Cancer Institute, Rockville, Maryland, United States of America
- Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center (UTHealth) School of Public Health in Austin, Austin, Texas, United States of America
- * E-mail:
| | - Kelley Pettee Gabriel
- Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center (UTHealth) School of Public Health in Austin, Austin, Texas, United States of America
- Department of Epidemiology, School of Public Health, The University of Alabama at Birmingham School of Public Health, Birmingham, Alabama, United States of America
| | - Harold W. Kohl
- Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center (UTHealth) School of Public Health in Austin, Austin, Texas, United States of America
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, Texas, United States of America
| | - Casey P. Durand
- Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, Texas, United States of America
| | - Deanna M. Hoelscher
- Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center (UTHealth) School of Public Health in Austin, Austin, Texas, United States of America
| | - Courtney E. Byrd-Williams
- Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center (UTHealth) School of Public Health in Austin, Austin, Texas, United States of America
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19
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Obesity and Body Composition in Preschool Children with Different Levels of Actigraphy-Derived Physical Activity-A Cross-Sectional Study. J Clin Med 2020; 9:jcm9041210. [PMID: 32340122 PMCID: PMC7230783 DOI: 10.3390/jcm9041210] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 04/17/2020] [Accepted: 04/21/2020] [Indexed: 12/26/2022] Open
Abstract
Detailed associations between physical activity (PA) and body composition in preschoolers remain unclear. The aim of this study was to assess body composition among preschool children differentiated according to their levels of PA and to assess whether meeting the current PA recommendations is associated with a lower risk of obesity, determined by body mass index (BMI) and body fat percentage (BFP). Free-living PA was measured using accelerometers for 7 days in children aged 5 to 6 years. Bioelectrical impedance analysis was used to estimate body composition. Significant differences in content of BFP, fat-free mass (FFM), and total body water (TBW) were found between boys meeting and not meeting moderate-to-vigorous PA (MVPA) recommendations. Meeting the MVPA recommendation was associated with a twofold lower risk of obesity determined by BFP in boys but not in girls. In contrast, the total number of recommended steps per day was not related to adiposity in boys or girls. No statistically significant differences were observed in body composition indices and quintiles of MVPA. Boys in the 3rd–5th quintiles of steps per day presented significantly lower BFP and higher muscle mass and TBW than their peers in quintile 1. However, different associations were observed between body composition indices and quintiles of PA.
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20
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Collings PJ, Dogra SA, Costa S, Bingham DD, Barber SE. Objectively-measured sedentary time and physical activity in a bi-ethnic sample of young children: variation by socio-demographic, temporal and perinatal factors. BMC Public Health 2020; 20:109. [PMID: 31992249 PMCID: PMC6986109 DOI: 10.1186/s12889-019-8132-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 12/30/2019] [Indexed: 12/26/2022] Open
Abstract
Background Evidence suggests that South Asian school-aged children and adults are less active compared to the white British population. It is unknown if this generalises to young children. We aimed to describe variability in levels of physical activity and sedentary time in a bi-ethnic sample of young children from a deprived location. Methods This observational study included 202 South Asian and 140 white British children aged 1.5 to 5y, who provided 3181 valid days of triaxial accelerometry (Actigraph GT3X+). Variability in sedentary time and physical activity levels were analysed by linear multilevel modelling. Logistic multilevel regression was used to identify factors associated with physical inactivity (failing to perform ≥180 min of total physical activity including ≥60 min moderate-to-vigorous physical activity (MVPA) per day). Results There were no significant ethnic differences in the overall levels of behaviours; South Asian and white British children spent half of daily time sedentary, just over 40% in light physical activity, and the remaining 7.5 to 8% of time in MVPA. Sedentary time was lower and physical activity levels were higher in older children, and levels of MVPA and vector magnitude counts per minute (CPM) were higher on weekends compared to weekdays. In South Asian children, sedentary time was lower on weekends. Sedentary time was lower and physical activity levels were higher in spring compared to winter in white British children, and in all seasons compared to winter in South Asian children. South Asian children born at high birth weight performed more MVPA, and in both ethnicities there was some evidence that children with older mothers were more sedentary and less active. Sedentary time was higher and light physical activity was lower in South Asian children in the highest compared to the lowest income families. South Asian girls performed less MVPA, registered fewer vector magnitude CPM, and were 3.5 times more likely to be physically inactive than South Asian boys. Conclusions Sedentary time and physical activity levels vary by socio-demographic, temporal and perinatal characteristics in young children from a deprived location. South Asian girls have the most to gain from efforts to increase physical activity levels. Trial registration The Pre-schoolers in the Playground (PiP) pilot randomized controlled trial is registered with the ISRCTN (ISRCTN54165860; http://www.isrctn.com).
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Affiliation(s)
- Paul J Collings
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK. .,Department of Health Sciences, University of York, York, UK.
| | - Sufyan A Dogra
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Silvia Costa
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, UK
| | - Daniel D Bingham
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Sally E Barber
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
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